Stage-0 Breast Cancer

Ductal Carcinoma Insitu (Intraductal carcinoma)-DCIS

Breast cancer originates from the epithelial cells lining the inner surface of the milk ducts or milk-producing lobules.

Initially, cancer occurs. cells proliferate within the cell layer where they started, they have no possibility of spreading in the body during this period, we call this situation "carcinoma in situ", as time goes by, cancer cells multiply and gain the ability to spread to the tissue surrounding them and then to distant tissues, which causes It is called "invasive carcinoma"

If ductal carcinoma in situ is not treated, there is a high probability of it turning into invasive carcinoma and gaining the ability to spread.

We detect breast cancer as early as possible. We try to catch it at the in situ stage (Stage - 0) if possible, and we can only achieve this by screening for breast cancer, because Stage 0 cancer will most likely not be palpable.

DCIS is treated surgically, meeting the criteria as a result of the pathological examination of the removed tissue. Accordingly, in some patients, hormone therapy with radiotherapy and tamoxifen may be applied to prevent recurrence or against the possibility of developing invasive cancer.

 

DCIS subgroups: According to the images of the cells under the microscope. These are determined subgroups.

• Comedo

• Comedo with necrosis

• Cribriform

• Solid

• Micropapillary

• Papillary

• Apocrine

The possibility of recurrence is higher in the comedo type with comedo and necrosis, so postoperative radiation therapy and hormone therapy are applied to these groups.

 

DCIS (ductal carcinoma insitu) Grades are "graded"

Grade is something different from staging. Staging indicates the status of the disease in the body. Grade is determined according to the findings in the cell during pathological examination. Grade provides information about the possibility of recurrence of the disease and helps determine the treatment protocol.

Grade 1 - Low grade-well differentiated: (Score 3-4-5) The probability of recurrence is less than other grades.

Grade 2- interme diate grade - moderately differentiated: (Score 6-7) The probability of recurrence is at a medium level.

Grade 3 - high grade - poorly differentiated: (Score 8-9) It is the most likely to recur, and postoperative radiotherapy and hormone therapy may be required.

 

Cell criteria examined for grade: 3 different scoring is done and the scores are summed.

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• Scoring based on the similarity of the cancer cell to a normal breast cell.

• Score:1 If it resembles a normal breast cell (Tubule structure is more than 75%)          

• Score:2 If it slightly resembles a normal breast cell (Tubule structure 10-75%)            

• Score:3 If it does not resemble a normal breast cell (tubule structure <10%)

• According to the size and shape of the cell nucleus

Score:1 uniform and small nuclei according to size       

Score:2  Cell nucleus shape is slightly larger and in different forms                       

Score:3 Cell nucleus is completely different in shape and size

• According to the Mitotic activity (proliferation rate) of the cell

Score:1  Mitotic activity is low                                                                          Score:2  Mitotic activity is moderate                                                                                          Score:2  Mitotic activity is medium. 3 Mitotic activity is high

 

When these scores are added together, a result between 3 and 9 is obtained and the grade is determined according to that score.

 

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